NPI | 1679695035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ 9155) |
Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IL 0051-036224) |
1835P1300X Pharmacist, Psychiatric (Licence: AZ 9155) | |
1835P1300X Pharmacist, Psychiatric (Licence: IL 0051-036224) | |
Enumeration Date | 2007-04-05 |
Last Update Date | 2007-08-30 |